青岛市健康幼儿及监护人手足口病隐性感染及相关因素分析  

Analysis of recessive infection of hand,foot and mouth disease and associated risk factors among healthy children and guardians in Qingdao

作　　者：信雪苓 张洪梅 纪乾鹏 贾静 王春辉 XIN Xueling;ZHANG Hongmei;JI Qianpeng;JIA Jing;WANG Chunhui(Department of Infectious Disease Prevention and Control,Qingdao Centre for Disease Control and Prevention/Qingdao Institute of Prevention Medicine,Qingdao(266033),Shandong Province,China;不详)

机构地区：[1]山东省青岛市疾病预防控制中心/青岛市预防医学研究院传染病防制所,266033 [2]青岛市崂山区疾病预防控制中心应急管理和传防科 [3]平度市疾病预防控制中心传染病防制科 [4]青岛市市北区疾病预防控制中心

出　　处：《中国学校卫生》2024年第5期732-736,共5页Chinese Journal of School Health

基　　金：山东省医药卫生科技发展计划项目(202112070250)。

摘　　要：目的了解青岛市不同流行期健康幼儿及监护人的手足口病隐性感染率及相关因素,为手足口病预防控制提供依据。方法采用整群随机抽样的方法,在2022年非流行期选择青岛市崂山区和平度市城镇和农村托幼机构各1所共4所托幼机构健康幼儿及监护人546份肛拭子样本作为研究对象,2023年流行期抽取市北区、崂山区和平度区城镇和农村托幼机构共6所,采集健康幼儿及监护人肛拭子样本690份,并开展问卷调查,采用Logistic回归分析手足口病隐性感染的相关因素,采用优势分析方法探讨相关因素对隐性感染影响的相对重要性。结果健康幼儿和监护人隐性感染率流行期分别为18.84%和13.62%,非流行期分别为9.09%和4.44%。多因素Logistic回归分析结果表明,居住于农村地区(OR=4.71,95%CI=2.57~8.61)和监护人隐性感染(OR=18.62,95%CI=7.45~46.56)的健康幼儿手足口病隐性感染风险较高,饭前/便后洗手(OR=0.09,95%CI=0.04~0.20)、独用毛巾(OR=0.17,95%CI=0.07~0.40)、接种EV71疫苗(OR=0.42,95%CI=0.20~0.87)的健康幼儿手足口病隐性感染风险较低(P值均<0.05);使用公用厕所(OR=3.02,95%CI=1.50~6.09)和每季度1次晾晒被褥(OR=3.89,95%CI=1.75~8.68)的监护人手足口病隐性感染风险较高,良好的住房采光(OR=0.31,95%CI=0.12~0.79)和餐具消毒(OR=0.31,95%CI=0.15~0.65)的监护人手足口病隐性感染风险较低(P值均<0.05)。优势分析结果显示,监护人隐性感染对健康幼儿手足口病隐性感染影响相对最重要(41.51%),餐具消毒对监护人隐性感染(28.87%)影响相对最重要。结论青岛市健康人群中手足口病隐性感染情况较为普遍,幼儿流行期隐性感染率较高,监护人在幼儿隐性感染中起重要作用。应针对重点人群加强健康教育,尤其是提高家长的防控意识,减少幼儿及监护人手足口病隐性感染的发生。Objective To investigate the recessive infection rate of healthy children and guardians in different epidemic periods of hand,foot and mouth disease(HFMD)in Qingdao,analyze the risk factors affecting recessive infection,so as to provide the basis for HFMD prevention and control.Methods In the non-epidemic period of 2022,the random cluster sampling method was used to selected 546 children and guardians from 4 childcare institutions in Laoshan District and Pingdu City.In the epidemic period of 2023,690 children and guardians were selected from 6 childcare institutions in Shibei District,Laoshan District and Pingdu District.A questionnair survey was conducted in the epidemic period.Logistic regression analysis was used to analyze the factors affecting the recessive infection.Dominance analysis was used to explore the relative importance of the risk factors affecting recessive infection.Results The results showed that the recessive infection rates of healthy children and guardians in the epidemic period were 18.84%and 13.62%,respectively;the recessive infection rates were 9.09%and 4.44%in the non-epidemic period,respectively.The results of multivariate Logistic analysis showed that rural areas(OR=4.71,95%CI=2.57-8.61)and recessive infection of guardians(OR=18.62,95%CI=7.45-46.56)were positively correlated with recessive infection of HFMD in healthy children(P<0.05).Washing hands(OR=0.09,95%CI=0.04-0.20),using towels alone(OR=0.17,95%CI=0.07-0.40),and EV71 vaccination(OR=0.42,95%CI=0.20-0.87)were negatively correlated with recessive infection of HFMD in healthy children(P<0.05).Public toilets(OR=3.02,95%CI=1.50-6.09)and drying bedding once per quarter(OR=3.89,95%CI=1.75-8.68)were positively correlated with recessive infection of HFMD in healthy guardians.Housing with good lighting(OR=0.31,95%CI=0.12-0.79),and tableware disinfection(OR=0.31,95%CI=0.15-0.65)were negatively correlated with recessive infection of HFMD in healthy guardians(P<0.05).The results showed that recessive infection of guardians was relatively the

关 键 词：手足口病 感染 回归分析 法定监护人 儿童 学龄前 

分 类 号：R179[医药卫生—妇幼卫生保健] R181.32[医药卫生—公共卫生与预防医学] R193